Although available for patients-undergoing coronary artery bypass grafting (CABG) for angina pectoris (1-3), necropsy data is lacking on patients undergoing CABG shortly after an acute myocardial infarction (AMI). Herein, we describe certain clinical and necropsy findings in 15 patients who underwent CABG within 1 month of onset of an AMI. The records of all patients having had CABG and studied subsequently at the Pathology Branch, National Heart, Lung, and Blood Institute, were reviewed. Fifteen patients had CABG without simultaneous left ventricular aneurysmectomy or cardiac valve replacement within 30 days of onset of AMI and they form the basis of this study. All 15 patients had the AMI before admission to a hospital. The heart weights ranged from 375 to 690 g (mean 517). Fourteen hearts (93%) were of increased weight (greater than 50 g in women, greater than 400 g in men). Findings in the above 15 patients who had AMI before entering the cardiac catheterization laboratory and operating room (for CABG) and who survived less than 60 days postoperatively were compared to those in 121 previously reported (3) necropsy patients who did not have an AMI (angina pectoris only) before CABG and who survived less than 60 days (Table II). Comparison between these 2 groups showed 1 important significant difference, the mean heart weight in the AMI group was significantly larger than that of the angina group (517 g vs 444 g). Of the 15 patients, 14 (93%) in the AMI group has hearts of increased weight compared to 84 of 121 patients (69%) in the angina (p less than .05).